Abstract
Background: End-stage renal disease (ESRD) presents a substantial and growing global health challenge, where hemodialysis serves as an essential life-sustaining therapy for countless individuals. Despite its physiological necessity, the demanding treatment regimen can profoundly impact mental health and overall well-being, though gender-specific data and correlates within the Saudi population remain insufficiently explored. Methods: This cross-sectional study aimed to investigate this gap by assessing the prevalence of anxiety and depression, evaluating health-related quality of life (HRQoL), and analyzing associations with gender and treatment duration in a cohort of 250 hemodialysis patients from multiple centers in Madinah, Saudi Arabia. Validated instruments, namely, the Hospital Anxiety and Depression Scale (HADS) and the 36-Item Short Form Health Survey (SF-36), were employed. Results: The findings revealed a significant psychological burden, with 38% of patients exhibiting anxiety and 32% depression, with females disproportionately affected. HRQoL scores were severely diminished across all domains compared to healthy population norms. Furthermore, a longer dialysis vintage demonstrated a significant positive correlation with worsening psychological scores and a decline in physical HRQoL. Conclusions: These results underscore the critical need for a paradigm shift in standard care, advocating for the systematic integration of routine mental health screenings and the development of tailored, gender-sensitive psychosocial interventions to mitigate this considerable burden.